Beautiful madness

This month’s Prospect magazine features a touching story about Nia – “..too beautiful to be in a psychiatric ward“. The true tale conveys elegantly the dilemma that often faces psychiatrists as they weigh up the benefits of antipsychotic medication against the side effects that can sometimes be worse than a patient’s original symptoms. In this story Nia’s beauty is ruined by the only drug that alleviates her psychosis – Olanzapine. What unnerves the psychiatrists is that she doesn’t seem to care, whereas they do. “The treatment had reversed a Faustian pact in which Nia had been beautiful and mad, and replaced it with another‚Äîin which she was fat and sane. But was it really a blessing that Nia seemed to have no conception of what she had lost?“

Link to story by deputy editor of Prospect Alexander Linklater and psychiatrist Robert Drummond (access to this item is free).

Tigger I don’t think the point of the story is that you have to be thin to be beautiful. I think it has more to do with the psychiatrist’s dilemma. They seem to have cured Nia but at what price? I think it’s understandable that the psychiatrists feel some guilt that they’ve destroyed Nia’s beauty. Nobody is suggesting you have to be thin to be beautiful. But that’s not inconsistent with the idea that in Nia’s case, her Olanzipine fuelled blow-out has made her less attractive. So OK, does beauty matter? Maybe not. But therein lies the crux of the story – does Nia have true insight into what has happened to her? It’s great that she doesn’t care being fat, unless her indifference is a side-effect of the drug or her mental illness. The psychiatrists know what they’ve taken from her… but does she? And if she doesn’t, they will never be able to rest easy in the knowledge that SHE has chosen to be sane and fat rather than mad and beautiful. Instead they’ve made that choice for her.